Judicial District of Danbury


      Medical Malpractice; Whether an Obstetrician was a “Similar Health Care Provider” Where the Alleged Acts of Malpractice were Committed by Three Nurse Midwives and a Registered Nurse who were Employed by the Institutional Defendants.  The plaintiff, Kristin Wilkins, brought this medical malpractice action against the defendants, Connecticut Childbirth & Women’s Center and Women’s Health Associates, P.C., alleging that three certified nurse midwives and a registered nurse, all of whom were either agents or employees of the defendants, engaged in negligent conduct while providing medical care to the plaintiff.  Pursuant to General Statutes § 52-190a (a), the plaintiff submitted with her complaint an opinion letter in which a board certified obstetrician and gynecologist opined that one of the certified nurse midwives departed from the accepted standard of care in caring for the plaintiff.  The defendants filed a motion to dismiss the action on the ground that the opinion letter failed to satisfy the requirements of § 52-190a (a) because it was not written by a “similar health care provider” as defined by General Statutes § 52-184c (c).  They maintained that, because the alleged negligence was committed by certified nurse midwives or a registered nurse, the plaintiff was required to submit an opinion letter that was written by a person who was certified in nurse midwifery or nursing.  The trial court agreed and dismissed the action.  On appeal, the plaintiff contended that the author of the opinion letter was a similar health care provider because the author has taught and supervised certified nurse midwives and was familiar with the standard of care that they are required to follow.  The plaintiff also emphasized that both obstetricians and nurse midwives provide obstetrical care to patients and that nurse midwives are required to work in collaboration with obstetricians.  She further contended that, because § 52-184c refers to individuals in defining a similar health care provider, the requirements of § 52-190a must be construed broadly where, as here, the defendants are institutions, not individuals.  She therefore maintained that the opinion letter was properly authored by an obstetrician given that the defendants were comprised of medical professionals who provided obstetrical care.  The Appellate Court (135 Conn. App. 679) rejected the plaintiff’s claims, finding that, under §§ 52-190a (a) and 52-184c (c), a medical professional’s knowledge of the applicable standard of care is irrelevant in determining whether the medical professional qualifies as a similar health care provider.  It also opined that, because the plaintiff’s opinion letter focused on the conduct of a nurse midwife without referring separately to any conduct of the institutional defendants, it was the actions of the individual caregivers that were relevant to the issue of negligence.  Accordingly, the court concluded that the action was properly dismissed in light of the plaintiff’s failure to submit an opinion letter from a person who was trained, experienced, and certified in nurse midwifery or nursing.  In this appeal, the Supreme Court will decide whether the opinion letter complied with § 52-190a (a).